Christian Medical and Dental Association v. Bonta (2022)

The Christian Medical and Dental Association (CMDA) is the United States affiliate of the International Christian Medical and Dental Association, with over 19,000 members nationwide, and over 20 locations in the state of California. The mission of the CMDA is to bring the hope and healing of Christ to the world through healthcare professionals and “change hearts in healthcare”. The CMDA is open about its mission, values, ethics, and commitment to defending its beliefs.

                                   

On January 1, 2022, the state of California implemented SB-380, legislation that forces physicians to participate in the process of assisted suicide, even when they have conscientious objections. The law mandates that doctors follow steps to help their patients commit suicide and removes all safeguards protecting physicians from involuntary involvement in assisted suicide. This legislation is an amendment to the existing End of Life Act and has several changes that would go into effect until January 1, 2026. Some of the changes include reducing the waiting period between the first and second oral requests from 15 days to only 48 hours, a final attestation is no longer required, the physician must document the requests by the patient and forward their medical records to a physician willing to do the procedure if they do not. Further, the law would result in requiring a physician to participate in 75% of the assisted suicide process despite firm conscientious objections, both religious and ethical.

On February 22, 2021, Alliance Defending Freedom filed a federal lawsuit against the California Attorney General Rob Bonta on behalf of CMDA to prevent the government from forcing health care professionals to violate their conscience, both with their personal religious convictions and professional ethics. Essentially, this case asks the constitutional question: Does the state of California’s legislation SB-380 violate the free exercise clause of the First Amendment by requiring physicians to participate in the process of assisted suicide?

I do believe that California’s SB-380 violates the free exercise clause of the First Amendment. The American Medical Association’s Code of Ethics says that physician-assisted suicide is “incompatible with the physician’s role as healer…” and would not reflect the values that they promote. The Affordable Care Act says that health care professionals must not be forced to participate in causing assisted suicide. Additionally, SB-380 would violate the Due Process Clause of the Fourteenth Amendment because it would allow the government to deny American citizens their unalienable right to life.

The legislation, SB-380, is not neutral or generally applicable because it is not neutral between religions and between religion and non-religion. Further, it is not generally applicable because respect for rights of consciousness is rooted in religious clauses and the law results in a disparate impact on physicians with religious beliefs. Further, there is a substantial burden on healthcare professionals with religious convictions because it forces them to participate in a process that ultimately ends someone’s life.

In Vacco v. Quill (1997), the Court said that New York’s ban on assisted suicide was constitutional because it was rationally related to the state’s legitimate interest in protecting medical ethics, preventing euthanasia, shielding disabled and terminally ill people from prejudice that may encourage them to end their lives, and the preservation of human life. In this unanimous ruling, the Court also made a distinction between refusing life-saving treatment and assisted suicide. Due to the fact that assisted suicide has the criminal elements of causation and intent, the Court said that no matter how noble a physician’s motive may be, he may not deliberately cause, hasten, or aid a patient’s death. In the same year, the Court had another unanimous ruling in Washington v. Glucksburg (1997) that Washington’s ban on physician-assisted suicide did not violate the Due Process Clause of the Fourteenth Amendment by denying terminally ill adults the liberty to choose life over death. In addition to the same legitimate state interest as Vacco v. Quill, the Court held that the right to assisted suicide is not a fundamental liberty interest protected by the Due Process Clause because its practice has been and continues to be offensive to our national traditions and practices.

Essentially, I believe that cases involving physician-assisted suicide fall into the same category as free exercise cases involving abortion. Religious convictions and one’s commitment to ethics and conscience should not be compromised because they chose a profession that faces tough challenges and situations every day. The physicians have the support of the American Medical Association’s Code of Ethics, the Affordable Care Act, the First and Fourteenth Amendments, and the precedents of the Court. As a result, healthcare professionals should not be put in a position where they have to choose between their ethics and their jobs.

Sources:

SB-380 Bill Text

Christian Medical and Dental Association (2022) - Spring 2022

Christian Doctors sue California over forced participation in assisted suicide